Training does not prevent back injuries

[Paul in Hobart]

http://www.sciencedaily.com/releases/2008/01/080131214541.htm

"Training showing the correct way to lift heavy objects does not prevent back injuries"

As we know the topic of back pain (which often has no underlying "pathological cause) is quite complex and responsible for a huge amount of community morbidity & suffering.

Often one hears the feedback "I've been told to strengthen up my back" , which according to this article may not be the sagest advice. Old "prescriptions" for health are hard to expunge when the alternative (multifactorial lifestyle advice) is so labour intensive and difficult to monitor.

Having gone through the RSI mill , attended by much helpful "advice" from a number of "experts" a few years back I know this to be "true".

What I have learned is that high repetition training which promotes full extension and normal posture helps undo years of bad patterning. And as long as we have 8 or so hours of sedentary and manual labour in our working days , we will need some efficient modality to undo the harmful patterning. A change of chair and some "stretching" is but the tip of the iceberg.

All you young pain free guys need to realise that at least 80% of adults suffer back pain. It's just a matter of time :cry: An ounce of prevention is certainly worth a pound of "cure".

As they say the back forgives, but it never forgets. Those of us who exercise vigorously yet mindfully I feel have a community duty to share our "secrets" with the population at large. Glib advice such as
"do more exercise" or "do some stretches" does not address the factors underlying back (and other) pain.

[abowe]

Come on Paul,
Glib advice is the best and most efficient kind, considering that most of our precious advice will never be followed. Most people whilst being nice are generally lazy! It is this lazyness that usually leads to their" back pain" ,not to mention stress and other psychological problems that may contribute.
Lazy people should heed our glib remarks like "stop eating", "do more exercise and stretches" because these kinds of fundamental lifestyle changes will actually help.
"Argue for your limitations......and sure enough they are yours"

LOL :lol:

[Paul in Hobart]

I know I know - I have found , though , the in your face attitude does not work well in a) changing the views of the fitness/rehab establishment and b) positively altering the perspective of lazy people , who immediately switch off and write you off as an exercise freak (as opposed to someone doing what the majority of the population does in an agrarian community.)

For success one needs to quickly get to the heart of the matter (a working diagnosis), explain it in simple yet scientific terms and attack from several quarters.

The "biggest loser" concept is incredibly flawed as we know - yet peddled by so called fitness "experts".

Truth is , everyone seems to want to be a victim these days. :oops:
And whole industries feed upon these victims...

[jefwil]

From 2001 - 2003 we ran twice a day 15min stretch & mobility program for Parking & Traffic in Melbourne CBD. One session was for the day shift & one for the afternoon shift. The aim was to reduce the Work Cover bill which was mainly from back injuries. About $2 000 000.00 per year. The program reduced the Work Cover bill to just over $200 000.00 per year. The program was cut shortly after. There theory: they make more money booking cars that looking after their staffs backs. The cost of the program was $35 000.00 across departments.

[winnie]

Back pain / stiffness......
I'm still looking for the secret. The few things I do that seem to help:
disclaimer- postural problems vary a lot across the population this stuff works for me but I still have some little niggles.

Duck walks and hanging around in the "third world squat" which is the very bottom of a body weight only squat with heels on the ground.

Making sure my knees are soft when receiving a weight ie. into the rack from a clean.

Hanging from something and relaxing / wiggling / rocking my legs around gently.

Lifting heavy stuff.

Dropping heavy stuff when my form or the lift turns to muck.

Sleeping on my back, not stomach.

Walking (I have dogs that get 1/2 to 1 1/2hours brisk walk per day) being aware of my posture. For me this means tucking my pelvis under a little which seems to straighten a lot of things out. I Know on bad days I probably look silly but no one has bothered to mention it to me :D

[Emily]

From 2001 - 2003 we ran twice a day 15min stretch & mobility program for Parking & Traffic in Melbourne CBD. One session was for the day shift & one for the afternoon shift. The aim was to reduce the Work Cover bill which was mainly from back injuries. About $2 000 000.00 per year. The program reduced the Work Cover bill to just over $200 000.00 per year. The program was cut shortly after. There theory: they make more money booking cars that looking after their staffs backs. The cost of the program was $35 000.00 across departments.

The article said:
"The researchers say either the advocated techniques do not actually reduce the risk of back injury, or workers do not significantly change their habits enough for it to make any difference." I believe the latter makes a huge difference. Compliance in these issues is a huge problem, and was obviously not monitored in this study. Information alone is no use unless it is acted upon. What was really being tested in this study was whether or not telling people what to do helped, not whether actually doing what they were told was effective. I believe this in conjunction with Jeff's anecdote suggests that if people are given sufficient supervision, motivation and support and are not just left to their own devices teaching people how to move properly can improve their back pain.

The other issue is time. The imbalances in the subjects would have been ones that have built up over a lifetime of bad habits and postural problems. This will not necessarily be undone quickly. I wonder what a study that looked at 40 year olds that had been taught to lift and move properly when they were 15 would reveal. I would argue their back pain would be significantly less than those who had suddenly been told to change their ways in their late 30s.

And while someone may still get back pain if they lift properly - I certainly get back pain and I believe I lift pretty well - there is absolutely no doubt in my mind that their risk of serious injuries such as disc prolapses is greatly reduced.

[Paul in Hobart]

http://www.sarahkey.com/extracts.cfm?pageID=8&extractID=10

A smart girl this one. Please spread the link around.

Emily you are right.

A lifetime of poor movement habits (and I too am guilty here as I spend many hours sitting in a non-natural way (hard to sit squatting @ work :) )
cannot be readily undone with a small amount of stretching/exercise. What is needed to overcome the problem is high repetition , healthy movements , without use of machines. Yoga and tai chi etc are perceived as too time consuming for many, and impossible to perform if you are feeling really stressed. So that's why ballistic kb work is important - it provides a focus , it diffuse stress and reeducates the postural muscles very efficiently.

" I have a dream..."

[reformer]

My two cents,
I would like to offer my perspective, esp' since I do understand and appreciate the kettlebellers perspective and I have also completed the A.P.M.A. pilates instructors course and because I work with back pathologies everyday.

5 important points for back health:

1. environment: unless you can hold an excellent posture all day, it may be necessary to modify your environment i.e. better chair, desk height, car seat, better bed etc etc.
2. Alignment: do a basic scan through the body; are the arches in your feet dropped, are your hips level and/or rotated, are your shoulders level, eyes eetcetc?...if not address these imbalances, as they will move there way up or down your body cause havoc; i.e. have you ever worn some dodgy shoes or flip flops and walked down the street and later found that it cause a sore back or knee ache very quickly! Pelvic alignment is crucial - so many people are in anterior tilt due to tight hip flexors it is amazing- and I have seem many 'fit and strong' people with quite kyphosis/lordosis.
3. Articulation ROM -Everyone has a theory on back mechanics, everyone from Stuart McGill, Paul Chek, physios, feldenkrais, franklin, alexander technique, osteos, chinese medicine etc: Although McGill argues that a full ROM is not warranted it has been my experience that full, controlled, precise articulation of the spine particularly extension, flexion, and also lateral flexion and rotation has amazing benefits: 1. it increases co-ordination through the spine and awareness through movement (very important) 2. the deep postural muscles (mutlifidus, semispinalis etc) become more efficient at their job 3. slower articulation really helps body awareness but also gets fluid moving (recent research has highlighted that degenerative disc pathologies can recover losing fluid via articulation through discs) 4. from an eastern perspective- stretching and lengthening through the spine is good for the organs, nervous system, smooth flow of energy etc etc . Pelvic curls into a roll-up are excellent daily exercise i.e. lying supine take in breath, as breathing out tuck tail under and articulate up on shoulder- pause, take an in breath - slowly articulate all the way down and return to a neutral hip position...also slow down through the parts of the spien i.e. thoracic or lumbar, which are not artiuclating nicely - you will find that regular practice for just a few weeks will dramatically improve the articulation throught the spine and overall back/body health.

4. Stretch: hammies, hip-flexors, Q.L., calves, stretch does make a huge difference...but also strengthen...the Afl/Nrl spends millions on research and development and they both have regular stretch sessions, aswell as yoga/pilates as part of their overall conditioning. One only has to look at the difference in Jonathan Brown after returning from intensive pilates work...he returned late in the season and was kicking longer, moving better etc etc. Stretch in fine attention to detail makes all the difference, and don't forget massage and foam rollers they work well to relax tight muscles.

5. Strengthen: long and strong hammies (single leg deadlift), wind mills (great lateral strength and Q.l. stretch), diamond presses (thoracic extension) lower traps (scap position), 4 point kneeling is fantastic.

Anyway just a few tips:
Move, pay attenion to posture and improve body awareness through some slower, precise movements, Strengthen appropirate muscle or movement patterns - and watch out for muscle patterning which is dominated by faulty muscle recruitment, stretching both dynamic and static is very important, allow your spine to have its natural curves which act as shock absorbers, obviously the spine and muscle, fascia etc which surround it need some sort of alignment to do their job well, if you out of alignment it is just a matter of time before the weak spot gives way.

Cheers.

[andrewmaher]

Don't forget the mindbody connection. Long term global emotional status can have a massive impact on not only posture but also how and where you store tension in any part of the body particularly along the spine.
You can do all the physical rehab/prehab movements all you want but without investigating aspects of whole health you are really only strengthening 1 side of the wellbeing triangle.

Previous mentioned ROM is massively important. Stimulation of spinal end range receptors has been shown to activate afferent central reflex pathways which stimulate a multitude of brain functions. In fact mechanoreception of this type has been shown to stimulate the cerebellum. To the point that healthy spine movement can be thought of as an essential brain 'nutrient'. The cerebellum is increasingly being seen as more than just the balance centre.

[winnie]

Spoke too soon in my previous post.
Dead lifting last week and things went badly= bulged disk still in a lot of discomfort